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Author: Admin | 2025-04-28
Treated with emollients. These drugs can cause pulpitis with painful fissures on the fingertips.The dry skin sometimes resembles seborrhoeic dermatitis.Keratoderma due to vemurafenib Dry skin due to vemurafenib ParonychiaParonychia refers to painful inflammation of the nail folds. Fingers are more frequently affected than toes. Paronychia can sometimes resolve spontaneously even with continued use of the drug, but it clears quickly on stopping it.Treatment involves avoiding trauma such as from tight shoes, avoiding excessive trimming or nailbiting, and wearing appropriate footwear. Topical steroids and antiseptics may help. It is essential to treat secondary bacterial and fungal infection.Skin cancerSquamous cell carcinoma and multiple keratoacanthomas have been reported to arise in patients on sorafenib and other EGFR inhibitors.What are the side effects of small-molecule tyrosine kinase inhibitors?The small molecule kinase inhibitors often block multiple enzymes meaning means there is some cross over in the actions and side effects of these drugs.The most common side effects are:Nonspecific rashesPeriocular oedemaAcral erythemaSplinter haemorrhagePigmentation changesPhotosensitivityThe same side effects may also arise with monoclonal antibodies .Nonspecific rashesImatinib induces a rash in a third of patients who start taking it, but this rash is generally self-limited. Imatinib has rarely been associated with vasculitis, Steven Johnson syndrome/TEN, and acute generalised exanthematous pustulosis (AGEP).A red facial rash is frequently seen within the first two weeks of treatment with sorafenib. It can appear very much like seborrhoeic dermatitis and usually settles without treatment. It can be associated with scalp tingling or dysaesthesia.Rash due to vemurafenib Facial swellingSwelling (oedema) of eyelids and face is common with imatinib and sunitinib. Oedema may also affect lower legs, lungs (pleural effusions) and brain (cerebral oedema).Acral erythemaAcral erythema (red hands and feet) is commonly seen with sorafenib and sunitinib. It presents as painful symmetrical red, swollen palms and soles. These drugs may also cause keratoderma/hyperkeratosis (excessive scale) and desquamation (peeling). Acral erythema tends to occur two to four weeks after starting treatment and is dose-dependent. It rapidly improves on stopping the drug and may not recur on restarting it.The small molecule kinase inhibitors tend to cause less extensive but more scaly acral erythema than that induced by
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